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Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson's disease.
Clin Neurol Neurosurg. 2012 May; 114(4):347-51.CN

Abstract

OBJECTIVE

Selective impairment of executive function has been shown in Parkinson's Disease (PD) patients undergoing Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN). However, some patients experience difficulties in daily life, such as dissension in interpersonal relationships or a loss of lifestyle balance, in the short term after surgery. Our hypothesis is that these difficulties might be related to executive dysfunction. To elucidate the involvement of executive dysfunction in these difficulties, we assessed motor and executive function in the short term and long term after surgery.

METHODS

We examined motor function and executive function in 30 patients who underwent bilateral STN-DBS for medically refractory PD. Patients were evaluated for executive function 1 month before surgery, 1 month after surgery, and 12 months after surgery using the Trail Making Test (TMT), the Modified Stroop Color Word Interference Test (MST) and tests of Verbal Fluency (VF).

RESULTS

TMT-B, TMT (B/A), MST-B, VF-phonemic and VF-semantic scores were significantly poorer 1 month after STN-DBS. TMT-B, TMT (B/A) and VF-phonemic recovered to preoperative levels by 12 months after surgery. A reduction in dopaminergic medication 1 month after surgery was significantly correlated with deterioration of TMT (B/A).

CONCLUSION

Temporary deterioration of executive function may occur in the short term after STN-DBS, whereas motor function is usually improved. PD patients undergoing STN-DBS should be managed during this period to better predict temporary executive dysfunction. Excessive reduction of dopaminergic medication after surgery might, at least in part, result in this deterioration of executive function.

Authors+Show Affiliations

Department of Neurology, Nagoya City University, 1 Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22176916

Citation

Yamanaka, Takehiko, et al. "Temporary Deterioration of Executive Function After Subthalamic Deep Brain Stimulation in Parkinson's Disease." Clinical Neurology and Neurosurgery, vol. 114, no. 4, 2012, pp. 347-51.
Yamanaka T, Ishii F, Umemura A, et al. Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson's disease. Clin Neurol Neurosurg. 2012;114(4):347-51.
Yamanaka, T., Ishii, F., Umemura, A., Miyata, M., Horiba, M., Oka, Y., Yamada, K., Okita, K., Matsukawa, N., & Ojika, K. (2012). Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson's disease. Clinical Neurology and Neurosurgery, 114(4), 347-51. https://doi.org/10.1016/j.clineuro.2011.11.009
Yamanaka T, et al. Temporary Deterioration of Executive Function After Subthalamic Deep Brain Stimulation in Parkinson's Disease. Clin Neurol Neurosurg. 2012;114(4):347-51. PubMed PMID: 22176916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson's disease. AU - Yamanaka,Takehiko, AU - Ishii,Fumiyasu, AU - Umemura,Atsushi, AU - Miyata,Miwako, AU - Horiba,Mitsuya, AU - Oka,Yuichi, AU - Yamada,Kazuo, AU - Okita,Kenji, AU - Matsukawa,Noriyuki, AU - Ojika,Kosei, Y1 - 2011/12/15/ PY - 2010/11/15/received PY - 2011/08/03/revised PY - 2011/11/05/accepted PY - 2011/12/20/entrez PY - 2011/12/20/pubmed PY - 2012/7/31/medline SP - 347 EP - 51 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 114 IS - 4 N2 - OBJECTIVE: Selective impairment of executive function has been shown in Parkinson's Disease (PD) patients undergoing Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN). However, some patients experience difficulties in daily life, such as dissension in interpersonal relationships or a loss of lifestyle balance, in the short term after surgery. Our hypothesis is that these difficulties might be related to executive dysfunction. To elucidate the involvement of executive dysfunction in these difficulties, we assessed motor and executive function in the short term and long term after surgery. METHODS: We examined motor function and executive function in 30 patients who underwent bilateral STN-DBS for medically refractory PD. Patients were evaluated for executive function 1 month before surgery, 1 month after surgery, and 12 months after surgery using the Trail Making Test (TMT), the Modified Stroop Color Word Interference Test (MST) and tests of Verbal Fluency (VF). RESULTS: TMT-B, TMT (B/A), MST-B, VF-phonemic and VF-semantic scores were significantly poorer 1 month after STN-DBS. TMT-B, TMT (B/A) and VF-phonemic recovered to preoperative levels by 12 months after surgery. A reduction in dopaminergic medication 1 month after surgery was significantly correlated with deterioration of TMT (B/A). CONCLUSION: Temporary deterioration of executive function may occur in the short term after STN-DBS, whereas motor function is usually improved. PD patients undergoing STN-DBS should be managed during this period to better predict temporary executive dysfunction. Excessive reduction of dopaminergic medication after surgery might, at least in part, result in this deterioration of executive function. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/22176916/Temporary_deterioration_of_executive_function_after_subthalamic_deep_brain_stimulation_in_Parkinson's_disease_ DB - PRIME DP - Unbound Medicine ER -